Prof Philip James, accompanied by Dr Tim Gill, the IOTF scientific secretary, presented a background paper outlining the health implications of growing levels of overweight and obesity worldwide, and also took part in roundtable discussions.

The obesity roundtable attracted 25 delegates with a strong representation from the Caribbean, but also included Mauritius, Malaysia, India, Australia and New Zealand as well as some NGOs. Delegates accepted a modified set of IOTF recommendations for further action, and agreed that the Commonwealth secretariat should help to sponsor regional action in co-operation with the taskforce. They also suggested that individual Commonwealth health ministers should raise the issue at the World Health Assembly in May.

The IOTF is now drafting on a joint plan of action with the Commonwealth Secretariat and is working to provide a handbook of practical advice and guidance on developing coherent national approaches to tackling the problem. Regional workshops will be held throughout the commonwealth, starting with the Caribbean and Pacific/Australasia.

The invitation to address Commonwealth ministers was made by Barbados health minister, the Honorable Elizabeth Thompson, who had talks with the IOTF at the World Health Assembly in Geneva last year. It is hoped that the Commonwealth group of health ministers will make a statement on obesity prior to the assembly session in May.

Commonwealth-IOTF workshop recommendations 

1. Obesity and undernutrition are both serious forms of malnutrition which often occur simultaneously in Commonwealth countries. Action on obesity should not undermine action on undernutrition.

2. Obesity is tightly linked to the chronic, non-communicable disease burden in many countries - remedial action is needed. In countries where obesity is not a problem - it soon will be - they have the opportunity to develop appropriate prevention strategies.

3. A focus on genetics will not lead to a cost-effective solution to this population-health problem.

4. A population- health approach is required which is nationally organized and employs multiple strategies aimed at increasing physical activity and improving diet by:

* changing food composition and production

* changing prices, access

* changing attitudes, knowledge and behaviour (health promotion)

* changing clinical practice (re: preventive control and management of obesity)

* creating an environment which supports physical activity in line with recommendations from the CHOGM Committee on Co-operation through Sport (CCCS).

5. A "settings" approach (e.g. Singapore) may have considerable promise for population health strategies, e.g. schools and workplaces.

6. Developing national leadership will be critical

7. Advocacy and leadership based on local evidence will be critical to success.

8. In addition to the above, the meeting supported the recommendations made in the paper by the International Obesity Task Force (attachment 1), which include those listed below, and commended them to governments for serious consideration.

9. Action by governments (individually and collectively) to work with the food industry to ensure more equitable access to healthy food choices.

10. The critical importance of essential national research on obesity (its prevent, management and complications) and related issues to underpin effective evidence-based action.

11. The commonwealth secretariat should consider how it could progress the issues of effective action to tackle obesity at a regional level within the Commonwealth in line with IOTF recommendations and approach.

12. The Commonwealth health Ministers should recommend to the WHA in 1999 that it give a high priority to action aimed at tackling the global epidemic of obesity.